If someone around you appears to show signs of a stroke, it’s critical to get him or her immediate medical treatment.
By Randy Davis, F471978
A stroke affects the brain like a heart attack affects the heart, especially if the stroke is caused by a clot in an artery supplying blood to the brain. That is why many medical experts call strokes “brain attacks.” Approximately 85 percent of strokes result from clots (ischemic); the rest occur because of bleeds (hemorrhagic). In both cases, damage can occur to a specific area of the brain. This damage is what causes the victim to exhibit stroke signs and symptoms.
It is imperative that a stroke be recognized early so that treatment can begin early. You must BE FAST in identifying symptoms and getting treatment for the victim. So, remember the acronym “B.E.F.A.S.T.” when dealing with a suspected stroke.
B = Balance. Is the patient able to walk in a straight line, or is he or she moving as though inebriated?
E = Eyes. Are both the victim’s eyes looking in the same direction? Is he or she experiencing any sudden vision issues?
F = Face. Ask the victim to smile. Look to see whether one edge of the mouth “droops” down instead of turning up when the individual attempts to smile.
A = Arms. Ask the patient to hold his or her arms out with palms up and eyes closed. Are they having trouble holding both arms up, or is one drifting down? Is a palm beginning to turn down?
S = Speech. Have the suspected stroke victim say the following: “You can’t teach an old dog new tricks.” If the victim slurs words, says wrong or inappropriate words, or cannot speak, then he or she is positive for stroke.
As a matter of fact, if the victim has a problem with any of the preceding checks, there is a 72 percent chance that he or she is having a stroke.
T = Time. If the patient has a stroke caused by a clot, clot-busting drug treatment MUST be administered within three to four hours from the time the victim was last noted to be normal. It is also time to call for emergency medical services (EMS), usually by dialing 911.
If a person has a sudden onset of any of the following symptoms, use the BE FAST check.
A sudden headache that is the worst ever felt (like a thunderclap)
A sudden onset of visual disturbances
A sudden loss of balance
A sudden loss of sensation or movement in an extremity on one side of the body
A sudden problem with speech
The patient should have his or her blood sugar checked, as irregularities can mimic signs of a stroke. The patient also should be transported immediately to a hospital that is a certified stroke center. That is where a rapid CAT scan can determine whether there is a bleed and, if not, blood-clot-busting drugs can be started rapidly.
What can you do? Never lay stroke victims flat; always keep them sitting or lying with their head elevated at about a 20- to 30-degree angle.
If victims are unconscious, lay them on their side to prevent aspiration (vomit or fluids in their airway).
Keep victims (and yourself) calm and get them to a stroke center immediately! Preferably, they will be transported by ambulance (emergency responders know which hospitals are designated stroke centers).
Never, ever give the patient aspirin! Remember that 15 percent of strokes result from a bleeding issue in the brain. Aspirin can make this condition worse, or even fatal. You cannot tell whether the stroke is caused by a clot or a bleed. This can be determined only in the hospital by exam and CAT scan.
If the symptoms resolve very quickly, the victim could be experiencing a TIA, or transient ischemic attack (mini-stroke). Transient means comes and goes. Ischemia is a lack of oxygen to tissue. A TIA could be a sign that a full-blown stroke may occur. The patient should be seen by a physician right away.
Randall J. (Randy) Davis is a nationally registered paramedic licensed in Missouri and Kentucky. His EMS career has spanned more than 40 years, first as an EMT in 1979, then as a paramedic beginning in 1981. He has presented numerous life-support classes for the American Heart Association, the American Academy of Pediatrics, and other nationally accredited education programs.